Dr Derrick Phillips argues for the use of an alternative to the Fitzpatrick scale
The Fitzpatrick skin type (FST) scale is a widely used classification system that was originally developed by American dermatologist Thomas Fitzpatrick in 1975 as a tool for assessing the propensity of the skin to burn during phototherapy for psoriasis. 1-4
The scale was designed for white populations, and in its original incarnation comprised four phototypes (I, II, III and IV) based on skin colour, tanning ability and reactivity to sun exposure.3,4 Black and brown skin were added as phototypes V and VI respectively to complete the scale.3
Over the decades, the Fitzpatrick scale has evolved into a tool used for describing constitutive skin colour, predicting skin cancer risk and projecting outcomes in skin surgery and laser treatment, all of which are beyond the scope of Fitzpatrick’s original vision.2,4,5
The simplicity of the scale and the lack of a suitable alternative has led to its widespread adoption in clinical practice. I argue that it is time to replace this outdated tool with a more objective…
